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Robot-Assisted Kidney Transplantation
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儿科移植:术内治疗对术后功能的影响
Lev M Botea1, Joelle Lane, Xinming An
1>From the Department of Anesthesiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina; and the Department of Anesthesiology, University of Texas Southwestern, Dallas, Texas, USA.
概括
维持适当的平均动脉压和使用外围止痛剂是儿童移植后功能改善的关键. 红细胞输血也会影响结果,而流体量和侵入性监测没有相关性.
科学领域:
- 肝脏病学
- 儿童手术
- 麻醉学
背景情况:
- 儿科移植结果可能会受到手术内生理管理的影响.
- 在手术期间优化器官 perfusion 对于移植功能至关重要.
研究的目的:
- 调查儿科移植患者的手术内因子和术后功能之间的相关性.
- 特别是检查平均动脉压,液体管理,血液动力学监测和外周止痛.
主要方法:
- 在2016年至2022年间接受移植的47名儿科患者 (<18岁) 的回顾性队列研究.
- 主要评估结果是手术后的第1天和第30天的血清肌水平.
- 分析了各种手术内参数与肌水平之间的相关性.
主要成果:
- 重量调整后的平均动脉压与第30天的肌素有显著的负相关性 (r = - 0.55;P < .001).
- 输血红细胞体积也与第30天的肌素负相关 (r = - 0. 73; P = . 0068).
- 在第1天和第30天,外周导管安置与血清肌水平显著降低有关,外周导管患者接受了更多的静脉输液 (82. 5与65. 2毫升/ 千克;P=0. 042).
结论:
- 平均动脉压,红细胞输血量和外周止痛疗法显著影响移植后的功能.
- 静脉输液总体和侵入性血液动力学监测与术后血清肌水平没有相关性.
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